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Beware of Possible Cuisine-Drug Interactions

This article was originally posted on RealClearScience.

Taking drugs, whether legal or illegal, creates problems. One of them is that drugs can interact with each other, often in bad ways. Frustratingly, some drugs are known to interact even with the various foods we like to eat. From the viewpoint of food-drug interactions, the most problematic food may be the humble grapefruit, which is known to interact with about 85 drugs, ranging from antidepressants and statins to clot-busters and Viagra.

Grapefruit isn’t the only troublemaker. Dairy, garlic, and caffeine have also been implicated. This fact led a team of Macedonian researchers to ask a much broader question: Are certain cuisines susceptible to adverse food-drug interactions?

To determine this, the team assembled data on known food-drug interactions and linked it to data on common ingredients found in the world’s cuisines. (See figure. The drugs are listed by ATC code, an international classification system. Also, note that the data is presented per mille, not percent.)

Panel A shows that Asian, Latin American and southern European cuisines will probably have adverse interactions with drug categories B, C and V, which affect blood/blood forming organs, the cardiovascular system, and “various” other locations, respectively. The authors specifically blame garlic and ginger as the problematic ingredients.

Panel B shows that drug categories D (dermatologicals), G (drugs affecting the genito-urinary system and sex hormones), and J (systemic anti-infectives, such as antibiotics and antivirals) will likely cause trouble for North Americans and most Europeans. They react with milk.

Panel C displays that category R (respiratory system) drugs are irksome throughout much of the world, mostly because of their interaction with coffee, tea and grapefruit. (However, note that the scale on panel C is much smaller than panel A and B, meaning there are far fewer possible cuisine-drug interactions for this category.)

Analyzing all the potential food-drug interactions, the authors determine that milk and garlic are the two most problematic ingredients in the world. (See figure. Panel A depicts where milk is commonly used, while Panel B depicts where garlic is commonly used.)

The authors point out that the spread of culture around the world — due both to globalization and travel — will bring people into contact with foods with which they have had little prior experience. Since about 70% of Americans are taking at least one prescription drug (and 20% are taking five or more), it would be quite useful to know how various cuisines interact with them.